- A syndrome of acute behavioral change associated with cessation of alcohol that occurs in some patients who chronically alcohol abuse
- Cant predict solely on basis of abuse; documented history of prior withdrawal is useful for predicting future events.
- Prior history of withdrawal
- Spectrum of symptoms from mild agitation to profound delirium/seizures (a.k.a. Delirium Tremens)
- Onset typically 24-72 hours after last drink (though can be as early at 6h or later than 72h)
- Initially mildly agitated/anxious, sweating
- Nausea, vomiting
- Can progresses to confusion, hallucinations (visual, auditory, tactile)
- Can progress further to combative/wild behavior; and at far end of spectrum, generalized seizures (3-5% will have severe symptoms)
- Can have similar symptoms with benzodiazapine withdrawal
- Can also have symptoms from coingestions (e.g.narcotics, meth/stimulants, etc)
- Tachycardia, hypertension, sometime febrile
- Difficult to keep focused, inattentive
- Can range from mildly confused/disoriented to profound hallucinations, agitation, seizures